中国实用妇科与产科杂志

中国实用妇科与产科杂志

• 专题笔谈 • 上一篇    下一篇

产科感染性休克的诊治

贺芳，陈敦金   

  1. 作者单位： 广州医科大学附属第三医院妇产科 广州重症孕产妇救治中心，广东 广州 510150
  • 出版日期:2016-12-02 发布日期:2016-12-06
  • 通讯作者: 陈敦金

Diagnosis and treatment of obstetric septic shock.

HE Fang，CHEN Dun-Jin.   

  1. Department of Obstetrics and Gynecology，the Third Affiliated Hospital of Guangzhou Medical University，Guangzhou Obstetrics Critical Care Center， Guangzhou 510150，China
  • Online:2016-12-02 Published:2016-12-06

摘要：

感染性休克是导致孕产妇死亡的重要原因。产科感染性休克可诱发早产、胎儿宫内感染的发生。妊娠期脓毒症起病隐匿，可迅速进展为感染性休克、多器官功能障碍乃至死亡。产科感染性休克的诊治依赖早期发现、及时识别感染源和有针对性的早期目标靶向治疗，包括1 h内启动容量复苏、经验性静脉使用抗生素、血流动力学监测等。感染科医师、熟悉妊娠期生理变化的重症监护医师及产科医师等多学科医师协作可以改善预后。

关键词: 感染性休克, 早期目标导向治疗, 并发症

Abstract:

Abstract：Pregnancies complicated by septic shock remain an important cause of death in obstetric patients. Septic shock is associated with increased rates of preterm labor and fetal infection. Onset of sepsis in pregnancy can be insidious，and patients may rapidly develop to septic shock，multiple organ dysfunction syndrome，or death. Its diagnosis and treatment rely on prompt recognition，detection of the source of infection and early goal-targeted therapy including aggressive hydration，initiation of appropriate empiric intravenous antibiotics within 1 hour and hemodynamic monitoring. Multidisciplinary team involving infectious disease specialists，critical care specialists with thorough understanding of the physiologic changes in pregnancy and obstetric specialists is effective in the best possible outcome.

Key words: septic shock, early goal-directed therapy, complication

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